A5017219998- Neonatal and fetal brain pathology
- Neonatal Respiratory Health Research
- Infection Control in Healthcare
- Infectious Encephalopathies and Encephalitis
- Fetal and Pediatric Neurological Disorders
- Central Venous Catheters and Hemodialysis
- Medical Device Sterilization and Disinfection
- Cardiac Arrest and Resuscitation
- Physical Education and Sports Studies
- Infant Development and Preterm Care
- Neuroscience of respiration and sleep
- Thyroid Disorders and Treatments
- Patient Safety and Medication Errors
- Antimicrobial Resistance in Staphylococcus
- Thermal Regulation in Medicine
- Traumatic Brain Injury and Neurovascular Disturbances
- COVID-19 and Mental Health
- Race, Identity, and Education in Brazil
- Nosocomial Infections in ICU
- Diagnosis and Treatment of Venous Diseases
- Forensic Anthropology and Bioarchaeology Studies
- Genetic Syndromes and Imprinting
- Venomous Animal Envenomation and Studies
- Autopsy Techniques and Outcomes
- Islanding Detection in Power Systems
Escola Superior de Enfermagem de Coimbra
2018-2023
Polytechnic Institute of Coimbra
2018-2023
Imperial College London
2015-2021
University of Aveiro
2019
University of Coimbra
2018
Perinatal Institute
2017
BackgroundAlthough therapeutic hypothermia reduces death or disability after neonatal encephalopathy in high-income countries, its safety and efficacy low-income middle-income countries is unclear. We aimed to examine whether alongside optimal supportive intensive care moderate severe south Asia.MethodsWe did a multicountry open-label, randomised controlled trial seven tertiary units India, Sri Lanka, Bangladesh. enrolled infants born at 36 weeks of gestation with need for continued...
In neonatal encephalopathy, the clinical manifestations of injury can only be reliably assessed several years after an intervention, complicating early prognostication and rendering trials promising neuroprotectants slow expensive. We aimed to determine accuracy thalamic proton magnetic resonance (MR) spectroscopy (MRS) biomarkers as predictors neurodevelopmental abnormalities observed encephalopathy.We did a prospective multicentre cohort study across eight intensive care units in UK USA,...
Although major cooling trials (and subsequent guidelines) excluded babies with mild encephalopathy, anecdotal evidence suggests that is often offered to these infants. We report a national survey on current practices for encephalopathy in the UK. From 74 neonatal units contacted, 68 were centres. received 54 responses (79%) and included 48 (five due incomplete data one found later not offer cooling). Of these, 36 centres (75%) infants encephalopathy. most of participating reported targeting...
Therapeutic hypothermia reduces death and disability after moderate or severe neonatal encephalopathy in high-income countries is used as standard therapy these settings. However, the safety efficacy of cooling low- middle-income (LMICs), where 99% disease burden occurs, remains unclear. We will examine whether whole body neurodisability at 18–22 months encephalopathy, LMICs. randomly allocate 408 term near-term babies (aged ≤ 6 h) with admitted to public sector units LMIC (India, Bangladesh...
Objective To examine the effect of therapeutic hypothermia on MR biomarkers and neurodevelopmental outcomes in babies with mild hypoxic-ischaemic encephalopathy (HIE). Design Non-randomised cohort study. Setting Eight tertiary neonatal units UK USA. Patients 47 HIE NICHD neurological examination performed within 6 hours after birth. Interventions Whole-body cooling for 72 (n=32) or usual care (n=15; these 5 were cooled <12 hours). Main outcome measures MRI spectroscopy (MRS) 2 weeks...
Background Despite the increasing interest in fetal and neonatal heart rate variability analysis its potential use as a tool for early disease stratification, no studies have previously described normal trends of healthy babies during first hours postnatal life. Methods We prospectively recruited 150 from ward continuously recorded their electrocardiogram (ECG) 24 Five-minute segments ECG (non-overlapping time-windows) with more than 90% consecutive good quality beats were included...
Although therapeutic hypothermia (TH) is the standard of care for hypoxic ischaemic encephalopathy in high-income countries, safety and efficacy this therapy low-income middle-income countries (LMICs) unknown. We aimed to describe feasibility TH using a low-cost servo-controlled cooling device short-term outcomes cooled babies LMIC.We recruited with moderate or severe (aged <6 hours) admitted public sector tertiary neonatal units India over 28-month period. administered whole-body (set core...
We examined the brain injury and neurodevelopmental outcomes in a prospective cohort of 10 babies with mild encephalopathy who had early cessation cooling therapy. All MRI spectroscopy within 2 weeks after birth assessment at years. Cooling was prematurely discontinued median age 9 hours (IQR 5–13) due to rapid clinical improvement. Five (50%) on or spectroscopy, two (20%) an abnormal outcome Premature therapy neonatal does not exclude residual adverse long-term outcomes. This study refers...
Although therapeutic hypothermia (TH) improves outcomes after neonatal encephalopathy (NE), the safety and efficacy of preemptive opioid sedation during cooling therapy is unclear. We performed a secondary analysis data from large multicountry prospective observational study (Magnetic Resonance Biomarkers in Neonatal Encephalopathy [MARBLE]) to examine association morphine infusion TH on brain injury neurodevelopmental NE. All recruited infants had 3.0 Tesla magnetic resonance imaging...
Objetivos durante a punção venosa periférica, recomenda-se o uso de um garrote acima do local da para potencializar distensão venosa. Dadas as suas características e em ambientes clínicos, os garrotes podem representar uma fonte disseminação micro-organismos. Entretanto, resultados estudos científicos nessa área estão dispersos na literatura. Esta revisão escopo tem como objetivo mapear evidências disponíveis respeito das práticas dos profissionais saúde no que concerne ao periférica à...
<h3>Introduction</h3> Despite cooling, adverse outcomes are seen in up to half of the surviving infants after neonatal encephalopathy. A number novel adjunct drug therapies with cooling have been shown be highly neuroprotective animal studies, and currently awaiting clinical translation. Rigorous evaluation these phase II trials using surrogate MR biomarkers may speed their bench bedside recent systematic review single-centre studies has suggested that spectroscopy offer best promise;...
Post mortem imaging is playing an increasingly important role in perinatal autopsy, and correct interpretation of changes paramount. This particularly following intra-uterine fetal death, where there may be maceration. The aim this study was to investigate whether any seen on a whole body post magnetic resonance (PMMR) correspond maceration at conventional autopsy. We performed pre-autopsy PMMR 75 fetuses using 1.5 Tesla Siemens Avanto MR scanner (Erlangen, Germany). images were reported...
<b><i>Background:</i></b> Variable responses to hypothermic neuroprotection are related the clinical heterogeneity of encephalopathic babies; hence better disease stratification may facilitate development individualized neuroprotective therapies. <b><i>Objectives:</i></b> We examined if whole blood gene expression analysis can identify specific transcriptome profiles in neonatal encephalopathy. <b><i>Material and...
Reusable tourniquets and conventional securement dressings are considered risk factors for the occurrence of reported complications catheter-related bloodstream infections. This study’s purpose is to assess impact single-use disposable advanced occlusive polyurethane with reinforced cloth borders on peripheral intravenous catheter (PIVC)-related contamination. A pre- post-interventional prospective observational study was conducted in a cardiology ward tertiary hospital between April 2018...
Peripheral venous catheters (PVCs) are the most used vascular access devices in world. However, failure rates remain considerably high, with complications such as PVC-related infections posing significant threats to patients' well-being. In Portugal, studies evaluating contamination of these medical and characterizing associated microorganisms scarce lack insight into potential virulence factors. To address this gap, we analyzed 110 PVC tips collected a large tertiary hospital Portugal....
A rapid and early diagnostic test to identify the encephalopathic babies at risk of adverse outcome may accelerate development neuroprotectants. We examined if a whole blood transcriptomic signature measured soon after birth, predicts neurodevelopmental eighteen months neonatal encephalopathy. performed next generation sequencing on ribonucleic acid obtained within six hours birth from first 47 recruited Hypothermia for Encephalopathy in Low middle-income countries (HELIX) trial. Two infants...
ABSTRACT Objective: To describe the determining factors in hand hygiene management among nurses and identify associated collective health challenges. Method: Cross-sectional descriptive study. Data were collected using a questionnaire that was applied four internal medicine units of hospital reference Portugal. Results: The sample composed 50 aged 26 to 55 years (mean age 34.88 years); 80% women, 58% had Bachelor’s degree, 5-30 nursing practice (X̄ =11.94;±5.92). vast majority (90%) reported...
BackgroundAlthough thalamic magnetic resonance (MR) spectroscopy (MRS) accurately predicts adverse outcomes after neonatal encephalopathy, its utility in infants without MR visible deep brain nuclei injury is not known. We examined MRS metabolite perturbations encephalopathic with white matter (WM) or cortical and associations outcomes.MethodsWe performed a subgroup analysis of all recruited to the MARBLE study isolated WM mixed WM/cortical injury, but no basal ganglia/thalamus (BGT)...
Introduction: The tourniquet used in venipuncture appears as a potential vehicle for the transmission of microorganisms that interferes with safety and qualityof clinical services. Objective: Mapping scientific evidence on microbiological contamination tourniquets peripheral venipuncture.Methodology: Scoping review following Joanna Briggs Institute methodology.Results: 20 studies have been included, which 1477 were analyzed. rates varied between 10-100% 19 reported presence S. aureus, 11...
A baby boy (39 weeks; 3350 g) delivered by forceps following shoulder dystocia was born in a poor condition requiring invasive respiratory support (Apgar scores at 1, 5 and 10 min were 3, 4 5, respectively). He started on passive cooling the local neonatal unit, then referred to our centre. At admission, had flaccid quadriparesis, …